Pediatr Crit Care Me
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Pediatr Crit Care Me · Oct 2014
Multicenter StudyNurse Decision Making Regarding the Use of Analgesics and Sedatives in the Pediatric Cardiac ICU.
To describe nurse decision making and patient responses associated with the administration of analgesics and sedatives in the pediatric cardiac ICU. ⋯ Pediatric cardiac ICU nurses use many nonspecific indicators to describe patient level of comfort collectively. Decisions for managing patient comfort were influenced by their patients' overall hemodynamic stability.
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Pediatr Crit Care Me · Oct 2014
ReviewIntegrating Palliative Care Into the PICU: A Report From the Improving Palliative Care in the ICU Advisory Board.
This review highlights benefits that patients, families and clinicians can expect to realize when palliative care is intentionally incorporated into the PICU. ⋯ Palliative care should begin at the time of a potentially life-limiting diagnosis and continue throughout the disease trajectory, regardless of the expected outcome. Although the PICU is often used for short term postoperative stabilization, PICU clinicians also care for many chronically ill children with complex underlying conditions and others receiving intensive care for prolonged periods. Integrating palliative care delivery into the PICU is rapidly becoming the standard for high quality care of critically ill children. Interdisciplinary ICU staff can take advantage of the growing resources for continuing education in pediatric palliative care principles and interventions.
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Pediatr Crit Care Me · Oct 2014
Observational StudyTranscranial Doppler-Based Assessment of Cerebral Autoregulation in Critically Ill Children During Diabetic Ketoacidosis Treatment.
Impaired cerebral autoregulation may be associated with poor outcome in diabetic ketoacidosis. We examined change in cerebral autoregulation during diabetic ketoacidosis treatment. ⋯ Impaired cerebral autoregulation was common early during diabetic ketoacidosis treatment. Although the majority improved during diabetic ketoacidosis treatment, 17% of subjects had impairment between 36 and 72 hours after start of insulin therapy. The observed impaired cerebral autoregulation appears specific to the diabetic ketoacidosis process in patients with type I diabetes.